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Researchers bet on mass medication to wipe out malaria in L Victoria region

 

Dr Jesse Gitaka, an infectious disease specialist, and his team may provide the solution to ending malaria in Kenya.

Together with specialists from the Kenya Medical Research Institute (Kemri), Nagasaki University, Japan and the University of Karolinska in Sweden, they are currently implementing a malaria eradication plan in Lake Victoria region.

The team is targeting mass treatment of villagers along the lake, blocking their ability to pass on the disease.

The malaria eradication plan was drawn by Dr Akira Kaneko, a world renowned specialist from Japan, who eradicated malaria in Vanuatu, a group of islands in the Pacific Ocean in the 1980s.

Mass medication is hoped to bring Nyanza region to the threshold of becoming the first malaria-free area in Kenya, although its the part of the country most blighted by the disease.

If Dr Gitaka and his team succeed, Nyanza will join more than 100 countries and regions that have eliminated malaria within their borders.

The team is using a combination of drugs to kill gametocytes which aid the spread of the disease in humans, lowering the chances of transferring malaria from an infected human to a mosquito.

“The idea is that if you kill the gametocyte in the infected human, when a mosquito bites a person, the insect will not leave carrying the disease-causing parasite. That is how we will stop the transmission,” said Dr Gitaka in an exclusive interview with the Business Daily.

“Mosquitoes in the community will be malaria free, and not in a position to transmit the disease. The prevalence will go down and malaria will be eliminated,” he said.

Mr Gitaka and a team of malaria specialists have over the last four years been studying the prevalence of the disease in malaria-stricken islands in Lake Victoria. Beginning this year, they launched mass treatment on Ngothe Island.

“Over the last four years we have been conducting surveillance studies on the island and we established that the prevalence is extremely high, with some islands recording up to 50 per cent rate in malaria occurrence,” he said.

The high prevalence indicate the challenges of taking on the malaria parasite and its insect hosts. Both are skilled at developing resistance to drugs or insecticides; and resistant strains tend to spread fast.

‘‘Our strategy is to kill all malaria parasites on the island to eliminate it completely in the population,” he said.

Mr Gitaka is confident that the disease can be completely eradicated, echoing this year’s ‘‘End malaria for good’’ theme. Mass medication will be complemented with insecticides and distribution of treated mosquito nets.

For the malaria specialists, the end is in sight for one of humanity’s deadliest plagues. The drugs proved successful in Aneityum, one of Vanuatu islands.

Dr Kaneko eradicated malaria on the island. All visitors getting on to the island were tested before being allowed to mingle with the rest of the people.

Dr Kaneko, with his team of researchers, also introduced fish that fed on mosquito larvae in ponds around the island.

The fact that people on the island were also isolated meant that the disease could be controlled. Constant surveillance followed and the island was declared malaria-free by 2000.

After eliminating malaria on that isolated island, his next challenge is Lake Victoria region. Although still a pilot project, it has bred optimism in Nyanza although initial studies have shown little progress in eradicating the parasite.

Data from Ngothe Island, Dr Gitaka said, revealed an insignificant improvement in the prevalence of the disease after the first treatment was carried out. The second set of figures also showed marginal change.

The researchers will conduct more tests in May to find out the project’s success.

“We have to follow up for a long period in order to study the changes and patterns of infection, so that we can craft ways of dealing with new infections resulting from the movement of people and stop re-infection. We need to ensure that anyone coming to the island is tested, and if found to have malaria, they should be treated immediately,” he said.
Dr Kaneko believes that eradicating the disease on Lake Victoria islands is possible but it will not be easy.

The Western region of Kenya, especially the area around Lake Victoria, remains the most affected by malaria in the country.

Data from the 2015 Kenya Malaria Indicator Survey shows that 27 per cent of children aged six and 14 years living in the area within and around Lake Victoria tested positive for the disease last year, the highest figure in the country.

It is the leading killer in Kenya. Every year, it kills around 30,000 people, a majority of whom are children. It accounts for 16 per cent of outpatient visits in the country.

Most of the developed world knows nothing of the disease, which they have tamed using dedicated preventive measures.

In the UK for instance, malaria is such a strange disease that in 2014, the death of a student volunteer, after a malaria attack in Kenya made headlines around the globe.

Christi Kelly, 21, had only been in Kenya for three months with an aid group in Siaya, when she got infected and died almost hours after the disease was detected.

But in Africa, malaria deaths rarely make headlines . The disease kill one million people every year, with a child dying every two minutes from the disease.

Kenya has however made great strides.

The national malaria prevalence dropped from 11 per cent in 2010 to eight per cent in 2015, with an even greater reduction in lake endemic areas.
About nine million Kenyans had malaria by 2014 compared to 11 million six years ago. Eradication efforts focus on preventive measures that have seen the Ministry of Health distribute 3.3 million nets to areas with high prevalence and set aside Sh200 million for spraying of homes with insecticides.

In addition, the government is set to start a pilot programme of administering a malaria vaccine in Kenya, although the timelines are not clear. The vaccine will target children between the ages of five to 17 months.

Waqo Ejersa, who heads the Ministry of Health’s Malaria Department said the vaccine is a big win because it has a direct correlation to child survival.

“WHO has picked Kenya as one of the countries where the pilot programme will happen, but the timelines are not clear because they are still seeking resources to get the programme started,” said Dr Ejersa.

And while most of the effort is aimed at preventing mosquito bites, many hope Dr Gitaka’s plan will stamp out malaria.